Manhattanville College

Refund Request Form

Last Name___________________________________________

First Name___________________________________________

Mville Email address___________________________________

Student ID #___________________________________

Phone Number__________________________________

Make Check Payable to_________________________________

• _______Will pick up
• _______Please Mail to the Following Address

________________________________________________________

________________________________________________________

I HAVE:

• _____A credit on my account and would like a refund.
• _____I have withdrawn from the college and would like a refund of any amount due to me.
• _____I have taken a leave of absence from the college and would like a refund of any amount due to me.
• _____I wish to donate_________from my refund balance to Manhattanville’s Annual Fund.
• _____I wish to use the credit to pay towards my Perkins Loan.

Please fax or e-mail form to 914-323-5384 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it   emailed forms must be sent from a Manhattanville email address.

____I acknowledge that I have read and understand all items on this form, that I have requested a refund from my student account at Manhattanville College, and that NO refund will be issued to me until the Office of Student Accounts has validated my request.

Please note refunds take 7 to 10 business days to be processed.

Student Signature__________________________Date________________

REFUND_REQUEST_FORM.pdf